Microscopic Colitis: Prostaglandin & Pelvic Cramp Connection
Here’s fascinating information on the possible connection between prostaglandins & pelvic cramping in microscopic colitis.
Can microscopic colitis cause pelvic cramps (low ab cramps or aching) even if there’s NO diarrhea going on?
I’m not referring to the lower stomach discomfort from diarrhea building up.
In fact, there may not even be any recent diarrhea or ANY at all in a flare episode, but the patient nevertheless has been diagnosed in the past with MC.
(In inflammatory bowel disease, aches and cramps can occur in the absence of clinical gut problems.)
“I haven’t seen many cases like this, but it’s possible,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“Different people may experience different symptoms, depending on their age, gender, diet, exercise patterns, overall health, family history, and a variety of other factors.
“Prostaglandins are a likely mechanism for this. Prostaglandins are chemicals that generally cause inflammation, which can irritate the stomach lining or cause other complications.”
Could pelvic cramping (in terms of location of the pain) be related to prostaglandins “running amok” and being released by the small intestines, causing spasms of their inner wall?
Dr. Fine explains: “This is conjecture, of course, but we know that prostaglandins are protective, so if they become overwhelmed or are turned off, there may be a shift in the cascade.
“We know that prostaglandins can cause contractions in the uterus, such as when PGE2 is used when a woman is in labor but isn’t contracting properly – so it is possible that the prostaglandins can cause contractions or muscle spasms elsewhere in the body.”
Fascinating!
In women, could microscopic colitis trigger prostaglandin release in the uterine muscle, thereby causing low abdominal (pelvic) cramping?
Though microscopic colitis is not a gynecological condition, I’m thinking that in terms of its associated prostaglandin release, there’s no discrimination where these chemicals are released.
“Other symptoms and conditions could become apparent with microscopic colitis,” says Dr. Fine.
“If prostaglandins are involved, they might trigger uterine contractions and/or muscle cramps.
“We know that prostaglandins can cause contractions in the uterus, when used in the medicine PGE2; so we can speculate that they might cause similar reactions in a woman who has microscopic colitis.”
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Zetar Infinity
Will Exercise Increase the Diarrhea from Microscopic Colitis??
Here’s what a gastroenterologist has to say about diarrhea, microscopic colitis and exercise.
Microscopic colitis is a benign though sometimes disruptive inflammatory bowel disease whose claim to fame is watery diarrhea — and lots of it.
The disease does not make people sick in the true sense, even though there may be brief waves of nausea right before the sudden urge of diarrhea hits. The nausea is relieved after the diarrhea is voided.
There may also be joint aches, but (at least in my personal experience with microscopic colitis) these don’t interfere with lifting weights or cardio.
“In general, exercise is good for you,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
Dr. Fine explains, “It increases your endorphins and helps you maintain good health overall. It shouldn’t increase the frequency of diarrhea unless you’re dehydrated.
“Make sure you’re drinking enough water. Usually I recommend an ounce of water per kilogram [of body weight] per day, preferably filtered.”
Exercise Interrupted by Frequent Trips to the Bathroom
For some people with microscopic colitis, trips to the bathroom to void diarrhea can exceed 10, even 15 times, per day.
Even though my flare-ups of MC were never this bad, I definitely noticed that while exercising at the gym, I never once had an episode of diarrhea.
If anything, exercise reduced the frequency of diarrhea — or, to put it another way, postponed it until I got back home.
It was as though my body somehow knew that being at the gym was not a good place to suddenly have the urge to void diarrhea.
If you have microscopic colitis, even with very frequent explosive diarrhea, and are afraid to commit to a gym workout — you might want to lift this restriction.
Who knows? Maybe your body will somehow know to keep the urge subdued until you return to the comfort and privacy of your home.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/ Oscar Carrascosa Martinez
Can Intermittent Fasting Reduce Diarrhea from Microscopic Colitis??
Find out what a G.I. doctor has to say about intermittent fasting and microscopic colitis.
Can intermittent fasting help relieve the symptom of diarrhea in microscopic colitis?
“At present, we do not know enough about microscopic colitis as a whole or about the specific effects intermittent fasting may have on it,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“However, diet can have a profound effect on the gastrointestinal tract and the body as a whole.
“If you have microscopic colitis or are concerned that you might have it, discuss it with your doctor.
“He or she can advise you on the best diet for you, given your condition, family history, fitness levels and other factors.”
What Is Intermittent Fasting?
Intermittent fasting is a dietary strategy that alternates between periods of eating and fasting.
Unlike continuous caloric restriction, which focuses on reducing overall calorie intake while still eating regularly throughout the day, intermittent fasting emphasizes the timing of food consumption.
In intermittent fasting, you cycle between periods of eating and fasting, such as eating within an 8-hour window and fasting for the remaining 16 hours of the day.
This method is popular for weight management and metabolic health.
The primary goal of intermittent fasting is to give the body extended breaks from food, potentially leading to improved insulin sensitivity, increased fat burning and other health benefits.
It’s different from caloric restriction, where you continually reduce your total daily caloric intake but still eat at frequent intervals.
Both approaches can have benefits, but intermittent fasting specifically targets the timing of eating rather than just reducing calories.
Microscopic Colitis or … Irritable Bowel Syndrome?
Shutterstock/Bannasak Krodkeaw
The only way to be diagnosed with MC is to have undergone a colonoscopy so that tissue samples can be taken from your colon and examined under a microscope.
IBS should not be given as a diagnosis until microscopic colitis has been ruled out, since the symptoms of these two conditions are very similar.
But the treatments, however, are different. That’s why a proper diagnosis is crucial for management and treatment to be effective.
Though there’s no studies supporting the application of intermittent fasting on the symptoms of microscopic colitis, it’s important that the patient determine which foods seem to trigger the diarrhea, and then work on eliminating or at least cutting back on those foods.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik.com/jcomp
Dog Keeps Scratching but no Fleas: Cause Can Be Serious
A veterinarian addresses various causes (including serious) of why your dog keeps scratching;don’t ignore this problem.
Your dog has no fleas but he keeps scratching.
What could be going on?
Where is your dog scratching?
“The first question to ask when your dog develops the itchies is, what part of his body is he scratching?” begins Dr. Jules Benson, BVSc, chief veterinary officer with NationwideDVM, a pet insurer company.
“If he’s paying particular attention to his ears, he could have an ear infection,” and this may run about $175 to treat.
“If he’s incessantly licking and chewing on his paws, legs or belly, it’s possible you’re dealing with either seasonal or food-related allergies, which are very common,” and may cost more than $400 to treat.
More Serious Causes of a Dog Continuously Scratching but no Fleas
“If it’s his whole body, it could be something simple, like dry skin, or something more serious, like sarcoptic or demodectic mange, which could range from $120 to more than $1,700 to treat,” explains Dr. Benson.
“Your veterinarian will be able to help you determine the exact cause of the itch, so bring itchy pets in for a check-up as soon as possible.”
Another possible explanation for frequent scratching in a dog that has no fleas is an allergic reaction to whatever cleaner you use on his pillow.
Dr. Benson is regularly consulted by many media outlets including ABC, NBC, FOX, The Wall Street Journal and The New York Times to provide pet health advice to pet parents nationwide.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Andrea Ravasio
Can Vaginal Atrophy Cause Brown Discharge?
Find out from a gynecologist if brown discharge from vaginal atrophy is something to worry about.
“Brown discharge caused by atrophy may be from small abrasions or scratches in dry vaginal tissues,” says Christine O’Connor, MD, FACOG, Director Adolescent Gynecology and Well Woman Care, Weinberg Center for Women’s Health, Mercy Medical Center, Baltimore, MD.
“This can be treated.”
If you have brown or tan vaginal discharge, you can’t tell simply by looking at it if it’s from vaginal abrasions, minute tears or a more concerning source.
More on Vaginal Atrophy
Declining levels of estrogen as a result of menopause cause the vaginal tissue to dry up. This can cause a very small amount of bleeding — very small — not flowing — and intercourse can bring it on.
The discharge of vaginal atrophy is usually some shade of yellow. Ask your gynecologist to extract a sample for viewing under magnification. This will help with the assessment of what may be causing the discharge.
A brown or tan discharge may be that color due to old blood, and this old blood could be from something going on in your uterus or a pathology with the cervix.
Dr. O’Connor states, “Another cause may be infections or abnormal postmenopausal bleeding. This brown discharge should be evaluated and mentioned to your doctor.”
Any new-onset discharge in postmenopause (or that which cannot be explained by menstruation during the fertile years) should be brought to the attention of your gynecologist.
Don’t just wait it out and see if it goes away on its own. Unfortunately, a time period during which the discharge has ceased does NOT rule out a malignant tumor.
Furthermore, really foul smelling discharge — often a fishy type of odor — often means an infection.
Finally, vaginal atrophy, in addition to discharge, often causes itchiness or burning in that area, as well as painful intercourse.
Additional symptoms include burning with urination and recurring urinary tract infections.
Dr. O’Connor is exceptionally skilled in minimally invasive/endoscopic and robotic surgeries.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Top image: Shutterstock/S_L
Is Cervical Mucus Normal after Menopause?
A gynecologist discusses postmenopausal cervical mucus: Is this normal? How much?
“I would venture to guess, the amount of cervical mucus produced after menopause varies amongst individuals,” says Alyssa Dweck, MD, a practicing gynecologist in Westchester County, NY, and co-author of the book, “V is for Vagina.”
There are numerous elements to consider when it comes to cervical mucus production in postmenopause.
This article isn’t about any type of discharge (such as that from an infection), but specifically, cervical mucus.
“Estrogen-like supplements such as soy (non-processed such as miso, tamari or tempeh, rather than soy protein bars and soy powders) or phyto-estrogens as well as aggressive hydration may contribute positively to vaginal health,” says Dr. Dweck.
“A healthy lifestyle with avoidance of smoking and treatment of chronic disease such as diabetes or cardiovascular disease, will enhance blood flow to the genitals to avoid dryness.”
But what if you’re already taking these healthful measures, are in postmenopause, and one day you notice some cervical mucus, when for months following menopause and even during this change, you were bone dry?
“I cannot think of any reason for cervical mucus secretion to increase or suddenly occur after a long period of none after menopause,” says Dr. Dweck.
“During perimenopause, estrogen levels wax and wane, so mucus production intermittently is not unusual.
“Suffice it to say, in the absence of any pathology (infection, Pap abnormality, medication change or items listed above), maybe this is just good fortune to those who have been suffering with dryness.”
If you’ve been having a resurgence of cervical mucus (not necessarily enough to “soak” your panties, but what would be considered a reappearance of the normal production of CM), and you’re concerned because you’re postmenopausal, then see a gynecologist.
At least if a recent Pap smear has come back normal, and the internal pelvic exam and external ultrasound also come back normal, you can be reassured it’s nothing to worry about.
If you recently completed menopause, this resurgence may simply be due to some residual hormonal activity that’s still working its way about.
Dr. Dweck
practices general gynecology and is proficient in laparoscopic and robotic gynecologic surgery. Her special interests are female sexual health and dysfunction.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Top image: ©Lorra Garrick
Can You Be Too Old to Get Cervical Cancer?
Yes, there is actually an age cutoff in which a woman just might be too old to develop cervical cancer — which in almost every case is driven by the HPV virus.
Christine O’Connor, MD, answers to if a woman can be too old to develop cervical cancer.
Should elderly women get a Pap smear?
“Cervical cancer rates are highest in the 35-44 age range; after this peak, the rates decline,” says Christine O’Connor, MD, FACOG, Director Adolescent Gynecology and Well Woman Care, Weinberg Center for Women’s Health, Mercy Medical Center, Baltimore, MD.
“For women who have had previous screening with normal Pap smears and are negative for high risk HPV, the risk of cervical cancer is minimal after 65 years old.
“Screening is not recommended in these patients, or in patients who have had a previous hysterectomy where the cervix was removed.”
Though the risk of cervical cancer is minimal in women of elderly age, this does not mean they are immune to this disease.
It’s just that the risk isn’t high enough for doctors to recommend regular screening in women over age 65.
Women of Elderly Age DO Get Cervical Cancer
The rate of diagnosis according to the National Cancer Institute Surveillance, Epidemiology and End Results Program is as follows:
- 11.4 percent of yearly diagnosed cases in the U.S. are in 65 to 74 year olds.
- In those 75 to 84 it’s 5.9 percent.
- In those over 84 it’s 2.5 percent.
So definitely, very elderly women can be diagnosed with cervical cancer, but this disease should not be anywhere near the top of their list of health worries.
There is no such thing as being immune to a gynecological cancer due to old age, but risks do change with different diseases and age brackets.
Women should discuss screening protocols for cervical cancer and other illnesses with their physicians.
If you see a primary care physician and a gynecologist for annual health and wellness exams, it will be easier for your doctor to tailor an individual health-check program.
Dr. O’Connor is exceptionally skilled in minimally invasive/endoscopic and robotic surgeries.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Top image: Shutterstock/Martina Ebel
Source: seer.cancer.gov/statfacts/html/cervix.html
What Can Cause Cervical Cancer Besides HPV ?
A tiny percentage of cervical cancer is NOT caused by the the virus known as HPV (which can be vaccinated against).
Perhaps you’ve read and heard repeatedly that cervical cancer is “caused” by the human papilloma virus (HPV).
However, in rare cases, cervical cancer is not related to HPV.
What “causes” cervical cancer not caused by HPV?
“HPV is detectable in 99.7% of all cervical cancers,” says Christine O’Connor, MD, FACOG, Director Adolescent Gynecology and Well Woman Care, Weinberg Center for Women’s Health, Mercy Medical Center, Baltimore, MD.
“This is why the HPV vaccine is so important in prevention of cervical cancer, although the vaccine only covers two of the types of high risk HPV.
“However, the two types included in the vaccine are responsible for 70% of all cervical cancers.”
The Other Type
“The percentage of non-HPV related cervical cancers is less than 0.3 percent,” says Dr. O’Connor.
This is why virgins should get a Pap smear. Frequency of the Pap smear in this case should be discussed with one’s doctor.
“One historical cause [of non-HPV disease] was DES [synthetic form of estrogen] exposure in utero, which is currently very uncommon, now that that medication has not been used during pregnancy in decades,” says Dr. O’Connor.
“The issue—speaking on a much more technical level—is that HPV affects approximately 80% of the population.
“And even though it is transmitted sexually, can be spread through skin to skin contact, so even a patient who is a virgin can be at risk since HPV is fairly ubiquitous.
“Also, women who have Paps which allow for early detection and intervention can often be ‘cured’ of cervical cancer, or even caught at the precancerous level.
“The deadliest cervical cancers are those found in patients who have never been screened or have had infrequent screening, since they have often already advanced to a higher stage.”
Dr. O’Connor is exceptionally skilled in minimally invasive/endoscopic and robotic surgeries.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Top image: Shutterstock/Chinnapong
Postmenopausal Cervical Mucus Production
Christine O’Connor, MD, OBGYN, answers questions about postmenopausal cervical mucus.
Cervical Mucus Production Postmenopause after Being Dry
I was postmenopause and bone dry, but then began getting increasing amounts of cervical mucus.
At first I didn’t think much of it: some small amounts of cervical mucus on my underwear, even though about three months prior, I had completed menopause.
I had also been bone dry down there for a number of months throughout menopause.
But then the cervical mucus began increasing. I found this rather concerning because, why would I begin secreting this fluid when I was postmenopausal?
My gynecological nurse wasn’t at all concerned about this. Neither was my gynecologist. It was like telling them I had a paper cut on my finger.
When I had a Pap smear, the doctor told me that she did not see any more, or any less, cervical mucus that she’d normally expect in a newly postmenopausal woman.
She also wasn’t the least bit concerned that the procedure had induced production of cervical mucus, to the extent that she gave me a box of tissues and a thick sanitary pad.
With the tissue I wiped and lots of cervical mucus came onto the pad (blood tinged from the procedure, which she had alerted me would happen, and that this was normal, since I was not sexually active).
How much had my cervical mucus increased from being bone dry?
Not enough to appear on a panty liner, but enough to make me want to wear a panty liner just in case.
There were several instances in which it came out in a gob onto the toilet paper, or plopped as a white ball into the toilet water from the pressure of urinating.
It was stretchy at one point, too, which made me wonder if I was ovulating.
After maybe about three weeks, I noticed that it began decreasing, exiting as gradually as it had came on.
I no longer felt a need to wear a panty liner, and began seeing less and less of the cervical mucus on my toilet paper. I eventually returned to being bone dry.
The Pap and internal pelvic exam were normal. The external ultrasound was normal.
My googling about this in postmenopause turned up a few things:
1) Vaginal atrophy, a postmenopausal condition, can cause vaginal “discharge.”
Whether or not this discharge can often look exactly like cervical mucus, I was not able to uncover.
2) If a woman is newly postmenopausal, her hormones may still be “settling” and not switching off like a water faucet, and hence, there may be a little resurgence of cervical mucus.
3) An infection can cause vaginal discharge. However, the description of this discharge does not fit ithe description of cervical mucus.
One description is that it resembles cottage cheese. Another is that it’s green.
An OB/GYN Doctor’s Response
As a medical writer, I inquired about postmenopausal cervical mucus to Christine O’Connor, MD, Director, Adolescent Gynecology and Well Woman Care, Weinberg Center for Women’s Health, Mercy Medical Center.
Here is what she says about postmenopausal cervical mucus production.
I also interviewed Alyssa Dweck, MD, a full-time practicing OB/GYN at the Mount Kisco Medical Group in Westchester County, NY, and co-author of the book, V is for Vagina. Below is my article featuring her explanations:
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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